Chief Inspector of Hospitals publishes his findings on the Nottingham University Hospitals NHS Trust

7 February 2014

England's Chief Inspector of Hospitals has today published his first report on the quality of care provided by Nottingham University Hospitals NHS Trust.

The trust was one of the first to be inspected under radical changes introduced by the Care Quality Commission which are designed to provide a much more detailed picture of care in hospitals than ever before.

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts, visited the trust announced in November visiting the trust’s two locations at Nottingham City Hospital and Queen’s Medical Centre.

The team examined the care provided in accident and emergency (A&E), medical care (including older people’s care), surgery, intensive/critical care, maternity, children’s care, end of life care and outpatients.

Overall, the report concludes that the trust was providing services that were safe, effective, responsive, caring and well-led; however, there were some areas for improvement.

Positive findings included good examples of leadership at the trust; most staff felt well supported by their managers and several staff reported that training and development opportunities were available to them. Doctors in training also felt well supported, and their consultants provided effective supervision and guidance.

The vast majority of people said they had positive experiences of care at the trust. The inspection team saw some good examples of compassionate care on the wards they visited and noted that staff interacted well with patients.

Inspectors found the A&E department at the Queen’s Medical Centre ran smoothly despite an increase of admissions. Staff were caring and compassionate, and staffing levels were appropriate during the inspection. There were some nursing and medical vacancies, but there were plans to fill the gaps as soon as possible.

The maternity service had good and effective leadership, and an open and supportive culture. Patients were mostly very complimentary about the care and dedication of the staff looking after them.

Inspectors found some areas where improvements were needed.

For example; there was a backlog of maintenance of clinical equipment. The trust was aware of this and had taken steps to manage this effectively by ensuring the highest risk equipment, such as breathing ventilators, were serviced according to manufacturers’ instructions. CQC was also concerned that not all staff had undertaken their mandatory training; however there was a plan in place and good progress was being made.

The inspection team received mixed feedback about the care people received at the outpatients department at Queen’s Medical Centre. Many patients were frustrated with the waiting times, whilst some patients said that despite the wait, they received good care.

The report, based on a combination of their findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations, will be available on CQC’s website on Friday, 7 February.

The Chief Inspector of Hospitals for CQC, Professor Sir Mike Richards, said: “We found that the Nottingham University Hospitals NHS Trust was providing services that were safe, effective, responsive, caring and well-led. Staff we spoke to were positive and engaged, and patients we spoke to were generally positive about the care that they had received at the hospital.

“There are improvements that could be made at the trust to improve the care delivered to local people, but overall we judge this to be a good trust.”

Dr David Levy, chairman of the inspection, said: “The inspection found that, overall, services at Nottingham University Hospitals NHS Trust were good. We found some very good examples of care being delivered.”

Whenever CQC inspects it will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

ENDS

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Notes to editors

Is it safe?

Overall, services were safe across the trust because there were systems for identifying, investigating and learning from patient safety incidents and there was an emphasis on reducing patient harm. We found nurse staffing levels were calculated using a recognised dependency tool in the adult wards which we considered to be good practice.

Is it effective?

Overall, the services at Nottingham University Hospitals were generally effective and were focused on the needs of patients. We saw examples of some excellent work. Patients got either the same or better results from their treatment at the hospital when compared with treatment given at other hospitals in England.

Is it caring?

The vast majority of people said they had positive experiences of care at the trust. We saw some good examples of compassionate care and we found staff to be hard working, caring and committed.

Is it responsive to people’s needs?

Overall, services were responsive and the trust responded well to people’s needs. We found the trust actively sought the views of patients and their families. We found that although there was good access to interpreting services, there was a lack of written information available in other languages.

Is it well-led?

Overall, trust was well-led. The trust board showed a good understanding of the key issues facing the trust. The executive team was well respected by staff. There were clear organisational, governance and risk management structures in place.

The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.

CQC inspectors will continue to monitor the Nottingham University Hospitals NHS Trust and will return in due course to carry out further inspections as part of its regulatory programme.

The Chief Inspector of Hospitals for CQC, Professor Sir Mike Richards, announced in July that he will lead significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public. Sir Mike identified 18 NHS trusts representing the variation of care in hospitals in England. These will be the first hospitals to test the new inspection regime.